Healthcare Provider Details

I. General information

NPI: 1306893813
Provider Name (Legal Business Name): PETER-PAUL U NWOKEJI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 6TH ST S SUITE 470
ST PETERSBURG FL
33701-4827
US

IV. Provider business mailing address

PO BOX 863298
ORLANDO FL
32886-3298
US

V. Phone/Fax

Practice location:
  • Phone: 727-767-4313
  • Fax: 727-767-4391
Mailing address:
  • Phone: 727-767-4378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01084805A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number01084805A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberME0060077
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: